Provider Demographics
NPI:1750713004
Name:ROSE VOCATIONAL EDUCATIONAL & TRANSITIONAL SERVICES
Entity type:Organization
Organization Name:ROSE VOCATIONAL EDUCATIONAL & TRANSITIONAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:N
Authorized Official - Last Name:MCGREW-ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:CRC
Authorized Official - Phone:601-757-8846
Mailing Address - Street 1:430 BRIARWOOD DRIVE, SUITE 400
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39206
Mailing Address - Country:US
Mailing Address - Phone:601-757-8846
Mailing Address - Fax:
Practice Address - Street 1:430 BRIARWOOD DRIVE
Practice Address - Street 2:SUITE 400
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39206
Practice Address - Country:US
Practice Address - Phone:601-757-8846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS302R00000X, 101Y00000X, 101YA0400X, 171M00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No302R00000XManaged Care OrganizationsHealth Maintenance OrganizationGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty